COVID-19 Cases Detection: Suspect Case Strategy
Abstract
Background and objective:Â as COVID-19 has triggered enormous human casualties and disastrous economic loss, the strategies to contain its spread are urgently needed. We aim to assess the value of our suspect case strategy on COVID-19 cases detection and ensure it to be a complement to the RT-PCR test. Materials and methods:Â from January 23 to April 30, 2020, patients admitted to our emergence isolation ward (EIW) were analyzed in this study. With RT-PCR as a reference standard, all participants were assigned to COVID-19 positive and negative groups. We compared the performance of the suspect case strategy, WBC, LYM, and chest radiography on COVID-19 detection. Results:Â one hundred twenty-five cases were analyzed in the study period. The receiver operating characteristic (ROC) curve revealed the sensitivity of WBC and LYM on COVID-19 detection was 92.11% and 76.31%, respectively. The sensitivity of the suspect case was 94.73%, and the sensitivity of chest CT was 53.33%. Statistically significant differences were observed for the suspect case, WBCs, LYM, and chest CT on COVID-19 detection. Discussion:Â suspect case strategy can help identify false negative RT-PCR tests and be a useful complement to RT-PCR in some countries with a tremendous shortage of RT-PCR agents and specialized laboratory during the COVID-19 outbreak.
References
[2] Pongpirul WA, Pongpirul K, Ratnarathon AC, et al. Journey of a Thai taxi driver and novel coronavirus. N Engl J Med. 2020; 382(11): 1067–1068.
[3] WHO. Rolling updates on coronavirus disease (COVID-19): WHO characterizes COVID-19 as a pandemic [Internet]. Available from: https://www.who.int/emergencies/diseases/novelcoronavirus-2019/events-as-they-happen 221–228.
[4] Chinazzi M, Davis JT, Ajelli M, et al. The effect of travel restrictions on the spread of the 2019 novel coronavirus (COVID-19) outbreak. Science 2020; 136–148.
[5] Leung K, Wu J, Liu D, et al. First-wave COVID-19 transmissibility and severity in China outside Hubei after control measures, and second-wave scenario planning: A modelling impact assessment. The Lancet 2020; 395(10233): 1382–1393.
[6] Kraemer M, Yang CH, Gutierrez B, et al. The effect of human mobility and control measures on the COVID-19 epidemic in China. Science 2020; 11–16.
[7] Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet 2020; 395(10223): 497–506.
[8] Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. The Journal of the American Medical Association 2020; 56–63.
[9] Prem K, Liu Y, Russell TW, et al. The effect of control strategies to reduce social mixing on outcomes of the COVID-19 epidemic in Wuhan, China: A modelling study. Lancet Public Health 2020; 87–95.
[10] Li Z, Yi Y, Luo X, et al. Development and clinical application of a rapid IgM-IgG combined antibody test for SARSCoV-2 infection diagnosis. Journal of Medical Virology 2020; 56–58.
[11] Lippi G, Simundic AM, Plebani M. Potential preanalytical and analytical vulnerabilities in the laboratory diagnosis of coronavirus disease 2019 (COVID-19). Clinical Chemistry and Laboratory Medicine 2020; 102–110.
[12] Yang Y, Yang M, Shen C, et al. Evaluating the accuracy of different respiratory specimens in the laboratory diagnosis and monitoring the viral shedding of 2019-nCoV infections. 2020. 88–95.
[13] Fan BE, Chong VC, Chan SS, et al. Hematologic parameters in patients with COVID-19 infection. American Journal of Hematology 2020; 98–103.
[14] Lippi G, Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clinical Chemistry and Laboratory Medicine 2020.
[15] Ai T, Yang Z, Hou H, et al. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: A report of 1014 cases. Radiology 2020; 108–112.
[16] Wee LE, Fua TP, Chua YY, et al. Containing COVID-19 in the emergency room: The role of improved case detection and segregation of suspect cases. Academic Emergency Medicine 2020; 27(5): 379–387.
[17] Office of State Administration of Traditional Chinese Medicine. Notice on the issuance of a programme for diagnosis and treatment of novel coronavirus (2019-nCoV) infected pneumonia [Internet]. Available from: http://bgs.satcm.gov.cn/.
[18] Sun Y, Koh V, Marimuthu K, et al. Epidemiological and clinical predictors of COVID-19. Clinical Infectious Diseases 2020; 71(15).
[19] Liu Y, Yang Y, Zhang C, et al. Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury. Nature Public Health Emergency Collection 2020; 63(3): 364–374.
[20] Ferrari D, Motta A, Strollo M, et al. Routine blood tests as a potential diagnostic tool for COVID-19. Clinical Chemistry and Laboratory Medicine 2020; 68–73.
[21] Dai WC, Zhang HW, Yu J, et al. CT imaging and differential diagnosis of COVID-19. Canadian Association of Radiologists Journal 2020.
[22] Lei J, Li J, Li X, et al. CT imaging of the 2019 novel coronavirus (2019-nCoV) pneumonia. Radiology 2020; 295(1): 200257.
[23] Shi H, Han X, Zheng C. Evolution of CT manifestations in a patient recovered from 2019 novel coronavirus (2019-nCoV) pneumonia in Wuhan, China. Radiology 2020; 295(1): 200269.
[24] Pan Y, Guan H, Zhou S, et al. Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): A study of 63 patients in Wuhan, China. Eur Radiol. 2020.
[25] Zhifeng J, Feng A, Li T. Consistency analysis of COVID-19 nucleic acid tests and the changes of lung CT. J Clin Virol. 2020; 127: 104359.
[26] Huang P, Liu T, Huang L, et al. Use of chest CT in combination with negative RT-PCR assay for the 2019 novel coronavirus but high clinical suspicion. Radiology 2020; 295(1): 22e3.
[27] Ruan Z, Gong P, Han W, et al. A case of 2019 novel coronavirus infected pneumonia with twice negative 2019-nCoV nucleic acid testing within 8 days. Chinese Medical Journal 2020; 133(12): 1487–1488.
[28] Zhou Y, Yang L, Han M, et al. Case report on early diagnosis of COVID-19. Disaster Medicine and Public Health Preparedness 2020; 1–4.
[29] Ng KQ, Poon BH, Puar THK, et al. COVID-19 and the risk to healthcare workers: A case report. Annals of Internal Medicine 2020.
Copyright (c) 2020 Zhongliang Ji, Kailin Lu, Xuedong Sun
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors submitting to USP journals agree to publish their manuscript under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0) where authors agree to allow third parties to share their work (copy, distribute, transmit) and to adapt it, under the condition that the authors are given credit, and that in the event of reuse or distribution, the terms of this license are made clear
Authors retain copyright of their work, with first publication rights (online and print) granted to Universe Scientific Publishing or the owner of the journal in question.
